Provider Demographics
NPI:1467440974
Name:KAUFFMAN, JEFFREY ELWOOD (DPM)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ELWOOD
Last Name:KAUFFMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 S QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-4941
Mailing Address - Country:US
Mailing Address - Phone:717-718-5511
Mailing Address - Fax:717-718-5381
Practice Address - Street 1:2410 S QUEEN ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-4941
Practice Address - Country:US
Practice Address - Phone:717-718-5511
Practice Address - Fax:717-718-5381
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005598213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1017924830001Medicaid
PA452133OtherHEALTHAMERICA
PA50063406OtherCAPITAL BLUE CROSS
PA1875012OtherBLUE CROSS BLUE SHIELD
PA5813030001Medicare NSC
PA102620VKJMedicare PIN